Monthly Archives:
October 2018

6 Best Practices for Engaging Employers and Members with CDHP Plans


by guest blogger Kathy Anderson, senior manager CDHP operations, HealthPartners


I recently worked with Jeff Bakke, WEX Health’s chief strategy officer, to cohost an America’s Health Insurance Plans (AHIP) webinar on consumer-directed healthcare plans (CDHPs) and how they can be used to improve employer partnership and member engagement. In addition to sharing the full webinar with WEX Health Partners (access it here), I’m highlighting some of the best practices that Jeff and I have come across in our work at our respective companies.


As uncertain out-of-pocket expenses and rising deductibles combine to put financial strain on more Americans, Jeff and I have both become passionate about the role that CDHPs can play in reducing financial stress and empowering employees to successfully manage their healthcare expenses. But first the challenge is to educate both employers and employees about the plans and to engage them with the accounts before and after open enrollment. Here are six of the chief learnings that Jeff and I shared in our webinar about maximizing engagement with CDHPs:


  1. Get involved as early as possible with a new employer. Getting on the same page with an employer is a must. If possible, review their existing plan documentation early on, and gain an understanding of their employee populations and how to best reach them. Not only will this inform your recommendations going forward, but it will allow you to inject account-based plans into the conversation from the beginning.


  1. Don’t overwhelm employees with information during open enrollment. Instead, give them the personalized experiences and communications they need when they need it. People can consume only what’s relatable to them in the present. Consider how you can deliver individual employee guided tours, and when certain tips and resources will be best received. Learn more about what consumers care about during open enrollment.


  1. Maintain personal touches with employees post-enrollment. Look for ways to continue to create in-person touchpoints with employees, whether with an outreach call after they experience their first medical claim with an HRA account or by hosting a brown-bag session where employees can have their individual questions about their CDHP answered. Here are some more examples of effective uses of personalization in healthcare benefits.


  1. When person-to-person isn’t feasible, email is the next best way to communicate. Some employees prefer paper, depending on industry and demographics, but overall, email is the preferred method for employees to receive information about their CDHP accounts. We’ve also learned that, for quick updates, people prefer text messages or automated notifications—e.g., “Your HSA available cash balance is below $250.00.”


  1. Help employees track and measure their healthcare goals online. Beyond just working with employees to establish an HSA or HRA savings goal at open enrollment, it’s important to provide tools for employees to be able to measure and track their progress toward that goal and to make changes as needed. Learn more about consumer-driven health and mobile technology.


  1. Give employees ongoing access to online tools and resources. Employees need to be able to have their account information at their fingertips when they want it. Dashboard views can give employees a consolidated snapshot of their experience and how their plan is working. People generally don’t spend a lot of time making decisions about their healthcare benefits, but if we can give them the data in an easy-to-use, accessible way, they’re more inclined to make better decisions as they move forward with their plans.


We invite you to watch our webinar in full here. And learn more about how personalizing is a key strategy for simplifying the business of healthcare.


Kathy Anderson

Senior Manager, CDHP Operations at HealthPartners

At HealthPartners, Kathy Anderson oversees the successful implementation of all Health Reimbursement Account and Flexible Spending Account plans. She partners with Sales to build and maintain strong client relationships and manages the daily administration of these products. She was also the Business Project Manager for the implementation of the WEX Health platform in 2016.

Prior to joining HealthPartners in 2001, Kathy worked as Manager of Health Plan Accounting at United Health Group and was an auditor at KPMG. Mrs. Anderson earned a Bachelor of Science degree in Management and Accounting from Drake University.

Trump Administration Proposes Plan for Employers to Use HRAs to Pay for Premiums


by Chris Byrd


The Trump administration proposed a new regulation this morning that would expand the use of health reimbursement arrangements (HRAs), giving employers of all sizes additional flexibility to provide greater choice to their employees. The proposed regulations issued by the Departments of Labor, Health and Human Services, and Treasury, allow employers to offer HRAs for reimbursement of individual health insurance premiums. In addition, employers who offer group health insurance would be able to offer HRAs of up to $1,800 (indexed for inflation) to reimburse certain excepted benefits, such as standalone dental benefits and premiums for a short-term health insurance plan.


HRAs are employer-funded plans that reimburse employees for medical expenses not covered by company-sponsored insurance, but the Obama administration had forbidden the use of them to pay for premiums on the individual market.


Building on President Trump’s executive order from October 2017, which called for expanded availability and permitted use of HRAs, the newly proposed rule would seek to “expand opportunities for working men and women and their families to access affordable, quality healthcare” through changes to regulations under various provisions of the Public Health Service Act, the Employee Retirement Income Security Act and the Internal Revenue Code.


The proposed regulations will be open for comment for 60 days from the date of publication. The proposed effective date is for plans beginning on or after Jan. 1, 2020.


At a high level, the proposed regulations build on the Qualified Small Employer HRAs (QSEHRAs) that were created by the 20th Century Cures Act in 2016. QSEHRAs allow small employers (1-49 employees) to offer HRAs to reimburse individual insurance premiums and/or out-of-pocket healthcare expenses. The proposed regulations expand the use of HRAs for premiums to all employers, regardless of size.


Whether this will lead mid-sized and large employers to get out of the business of offering group health insurance remains to be seen and will depend in large part on such factors as relative costs in the individual and group markets (current big advantage to group health) and tax advantages associated with the employee-paid portion of group health premiums.


Another possible trend would be for employers to offer the HRA as an option on a menu alongside group health, so that the employee has a wider choice of insurance plans and, for lower-income workers, access to subsidies on the public exchanges.


The excepted-benefit HRA represents a new product that provides employers with another way to provide benefits beyond traditional health insurance. Keep in mind that, to offer this HRA, the employer must also offer group health insurance.


One thing is certain: The proposed regulations open up new product opportunities for administrators to provide to employers, and they would benefit those employers by enabling them to offer a wider choice of benefit options to their employees. This is consistent with other recent moves by the current administration, such as the expansion of short-term health insurance plans.


WEX Health will be studying the regulations carefully, commenting on them to regulators, working with our colleagues in the industry and making any platform changes required to accommodate these new and expanded products.


Learn more about HRAs on our blog, and follow us on Twitter to keep up with the latest changes impacting consumer-directed healthcare in the United States.


Chris Byrd

Executive Vice President, WEX Health Operations & Corporate Development Officer

Chris Byrd brings more than 25 years of experience in employee benefits and banking to his role at WEX Health. A founder of Evolution Benefits in 2000, Chris played a key role in designing the proprietary architecture for the company’s prepaid benefits card.

Chris oversees the daily execution of WEX Health’s business and leads the company’s operations and service delivery, corporate development, merger and acquisition activity, and legal, industry, and government relations efforts.

He began his career in commercial banking, and prior to 2000, he focused on finance, strategy, and business development for Value Health and two start-up healthcare companies. He joined WEX Health in July 2014.

Chris, who serves on numerous industry boards, is a frequent speaker on emerging trends in financial services and benefits and is active in industry and government relations. He earned a degree in economics from Brown University.  

Sudden Health Expense Anxiety Syndrome

Sudden Health Expense Anxiety Syndrome: Why Americans Have It and How to Cure It


by Jeff Bakke


Are you familiar with Sudden Health Expense Anxiety Syndrome (“SHEA Syndrome”)? Unless you attended Partner Conference, where I spoke about it alongside Chris Byrd, the Center for Financial Services Innovation (CFSI) and Gartner Group, you likely haven’t heard of it. That’s because I made the name up, and I apologize to you and everyone in the health and wellbeing industry for the lousy acronym.


Despite the acronym, this is a real problem. I am sure that you’re already familiar with the syndrome. SHEA has everything to do with how Americans’ declining financial health is impacting their actual health. It’s enough to make them sick: One worker study found that employees with high financial stress are twice as likely to report poor health overall and are more than four times as likely to suffer from fatigue, headache, depression or other ailments.


SHEA Syndrome has grown into an epidemic, and escalating out-of-pocket maximums and healthcare deductibles are one of the prime culprits, having risen quickly from a few hundred bucks on average less than a decade ago to around $1,500 today—even more than that if you work for a small employer. That’s meaningful in a country where more than half of people have less than $1,000 stashed in a savings account. Consider that there are now just as many people who lie awake at night worrying about the cost of a future healthcare expense ruining them (“I have a $1,500 deductible, but only $300 in the bank”) as there are those who are worried about a future healthcare event impacting their wellbeing (“I hope I don’t get cancer”). That’s truly astounding.


Fear of medical bankruptcy is starting to have a real impact on Americans’ psyche. Nearly one in three workers reports that financial stress has been a distraction at work. This, of course, leads to lost productivity, absenteeism and the rise of something called “presenteeism,” whereby an employee is physically present but is performing suboptimally because of stress, illness or both. Unsurprisingly, out-of-pocket expenses hit low-to-moderate income households hardest, but even high-income workers report significant financial health struggles.


Consumer-driven healthcare: A cure for consumers’ ailing financial health?


According to CFSI, “Employers who address the financial health of their workforce can see stronger business results through higher productivity, increased employee loyalty and an improved reputation.”


One of the products that’s proven to be an antidote for SHEAS is the consumer-driven healthcare (CDH) account, which allows consumers to set aside money at each pay period, earmarking it explicitly for healthcare expenses. Though health savings accounts (HSAs) are talked about most often in the market today and are the best long-term healthcare savings vehicle, there are actually more FSA account holders in the U.S. Both types of accounts are important and interesting, and both are excellent at helping Americans brace for a financial shock related to medical bills.


CDH accounts benefit all stakeholders—employees, employers and providers


The benefits of CDH accounts extend to all stakeholders. For employers, who have struggled to create a stronger level of personal responsibility for their workers’ health while they also try to help them deal with rising deductibles and other financial stress, CDH accounts allow them to present a solution that will both give their employees more skin in the game for their physical health and financial health, as well as provide a retirement savings vehicle that includes all the positives of a 401k plan plus the option to take tax-free withdrawals at any time for healthcare expenses. And, by reducing employees’ financial stress, employers get more productive, focused employees.


For the providers, which were once paid primarily by third parties and are now paid—or in many cases, not paid—directly by consumers, CDH accounts are helping solve the massive medical debt problem. The solution they offer up is ideal: a debit card that the consumer hands to a provider on the spot so that the provider is paid instantly instead of many months later or not at all. With the WEX Health Cloud platform, consumers can log in, click a button and pay providers right out of their CDH account.


The biggest barriers to CDH account adoption? Education and resistance to change.


No one has ever said that selecting health and financial benefits was fun. When it comes time for benefits enrollment, consumers are oftentimes not doing the work to review their healthcare and financial options, and are likely to pick whatever plan they had last year or the plan that’s cheapest. This plan usually has the highest deductible. Rather than thinking about their risk over time and setting aside the savings in a healthcare account, they’re setting themselves up for failure by thinking about having another $100 left in their paycheck at the end of the month versus $1,200 at the end of the year that would create a buffer for medical expenses. This behavior can quickly develop into SHEA Syndrome.


To encourage more opt-in thinking versus opt-out thinking and actually reduce financial stress, the CFSI says that employers’ financial education efforts need to be coupled with products and services that encourage behavior change and help employees better plan, save, spend and borrow to optimize their physical and financial health.


The WEX Health Cloud platform is unique to other solutions in the marketplace in that we power HSAs, FSAs, health reimbursement arrangements (HRAs) and other tax-advantaged benefit accounts well whereas our competitors generally excel at only one. Another differentiator: We distribute through health plans, third-party administrators and banks, which know precisely how to pair CDH accounts to health plans to put all stakeholders in the best possible position for achieving financial health. Learn more about the WEX Health Cloud platform.


Jeff Bakke WEX Health

Jeff Bakke

Chief Strategy Officer at WEX Health

At WEX Health, Jeff oversees corporate strategy, distribution strategy, and strategic partnerships. A specialist at identifying and capturing business opportunities, Jeff has built and led innovative high-performance teams, developed new products and markets, and developed large strategic clients with exceptional recurring revenue results. He has been instrumental in WEX Health’s focus on the emerging exchange market as well as a continued emphasis on HSA market opportunities.

Jeff’s career includes working at SafeNet, Blue Cross and Blue Shield of Minnesota, Medica Health Plans, Allianz and American Express. He earned a degree in electrical engineering from University of Minnesota-Twin Cities.

Personalizing: A Key Strategy to Simplifying the Business of Healthcare

Personalizing: A Key Strategy to Simplifying the Business of Healthcare


by Jeff Young


You’ve likely read the articles and seen the studies touting the power of personalization in engaging consumers. When it comes to their healthcare benefits, the same applies—U.S. workers have an overwhelming preference for personalized communications, online tools and resources, as demonstrated by our own Clear Insights Report earlier this year.

As we gear up for open enrollment, we want to share examples of personalization that we hope inspire you—whether you’re an employer, benefits broker or third-party administrator—to get personal in ways that help both you and consumers meet their goals this year.


A Competitive Advantage, Especially with Millennials

When you personalize healthcare benefits communications, you provide a highly targeted, relevant consumer experience that’s been shown to drive increased enrollment, contributions and rates of saving, as well as increased consumer value and engagement. You’re also simply meeting consumer demand, as 74 percent of polled workers say they feel frustrated when web content isn’t personalized, and 63 percent say they’d think more positively of a brand if it gave them content that was more valuable, interesting or relevant.

It’s worth noting that millennials, which became the largest generation in the labor force as of 2016, appear to be the most discerning when it comes to personalization, or more specifically, the lack thereof: Their adoption rates for online portals, mobile apps and email are lower than most people expect. If it’s not personalized or customized, millennials are most likely ignoring communications and hitting delete.

Today’s focus on personalization is also driven by the massive amounts of consumer data that most employers and benefits administrators find themselves sitting on. You’re being presented with unprecedented opportunities to sort this information in ways that helps consumers be more engaged, educated and prepared.


Tell Them What Matters Today

Rather than blast out a one-size-fits-all message to consumers, build rules-based messages to target them based on specific criteria, for example:

  • Custom messages on hero banners, portal homepages and/or post-login prompts can be configured around demographics such as a consumer’s age, state of residence, if he/she has a dependent and more.
  • Text can be targeted around account specifics like whether or not consumers have set a health savings account (HSA) savings goal or have HSA dollars to invest, what type of plan they’re enrolled in, how much money is in their cash account and/or their investment account, and the amount and type of transactions on their HSA debit card.


Help Consumers Maximize Their Dollars

Employers and benefits administrators today are most often introducing custom content that creates consumer awareness regarding expected out-of-pocket costs. Here are some examples of how data can be turned into actionable content:

  • Because younger audiences typically have the benefit of time, employers can target messaging to them about the importance of starting healthcare savings accounts early.
  • Workers age 55 and over with an HSA can be targeted with messaging reminding them that they have a higher maximum contribution.
  • A banner image can remind flexible spending account (FSA) participants to spend their money before runout is over.
  • Cost-saving tools can be tailored to family size, account balance or spending activity, and links or displays can be filtered around specific state regulations or transit authority messages with features and functionality provided through WEX Health Cloud.
  • A text can be sent reminding HSA participants who have dependents that they can use their HSA dollars for things like contact solution, sunscreen, first aid kits, blood pressure monitors, glucose monitors, thermometers and more. (The WEX Health Cloud mobile app also now allows users to scan an item to see if it qualifies as an HSA-eligible expense.)


To measure the power of personalization, the WEX Health Cloud Administrator Dashboard helps benefits administrators see the state of your CDH account-based business, allowing you to better manage and monitor growth, efficiency and engagement across your organization.

Personalization leads to better consumer engagement and efficiency, which leads to helping consumers maximize their health benefit accounts, and ultimately, that’s what it’s all about: simplifying the business of healthcare.


For more information and ideas on personalizing communications and experiences for consumers, check out our Clear Insights Report. And be sure to read our blog post and to follow us on Twitter to keep up with WEX Health happenings.


Jeff Young

President, Health | WEX Inc.

Jeff joined WEX in 2014 when the company acquired Evolution1 to expand its healthcare payments business. He spearheads the company’s efforts to simplify the business of consumer-driven healthcare and is responsible for WEX’s growing healthcare business, with a focus on industry-leading technology and a strong partner network. Before joining Evolution 1 as CEO and chairman in 2008, Jeff was the vice president of business applications at Microsoft Corporation in the U.S., and prior to that, he held senior leadership positions at Great Plains Software, helping lead Great Plains through its successful IPO and eventual sale to Microsoft for more than $1 billion. A graduate of the University of Jamestown (N.D.), Jeff serves on the boards of Bell Bank in Fargo and West Fargo (N.D.) Baseball.